HOW DOES ADVANCING AGE AFFECT IMMUNE SYSTEM FUNCTION?
This debatable point is the focus of much research. The goals of antiretroviral therapy remain the same regardless of patient age: restoring immune function as measured by increased CD4+ T-cell counts and viral load suppression. Equally important is the management of comorbidities such as lipid-level abnormalities, diabetes, and hypertension. Two studies are often cited to highlight the differences in treatment response among younger and older adults.10,11 Results from the AIDS Clinical Trials Group (ACTG) 384 study showed that younger age (40 years or younger), female sex, higher baseline viral load, and virological suppression were associated with greater increases in CD4+ T-cell count at 48 weeks of treatment.10 When stratified by age, patients 40 years and younger had significantly higher CD4+ T-cell counts while receiving treatment than those older than 40 years. The converse was shown by Silverberg and colleagues.11 Within 1 year of starting highly active antiretroviral therapy,
